Kelly, Andrea
Kelly, Andrea is an individual health care provider with primary practice located at 2908 Auburn Rd , Huntington WV 25704-2715. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Kelly, Andrea can be contacted via phone (304) 781-5800.Contact Information
Primary practice address
2908 Auburn Rd
Huntington WV 25704-2715
Phone: (304) 781-5800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 3487 | West Virginia |
Profile Details
| NPI number | 1023098811 |
|---|---|
| LBN Legal business name | Kelly, Andrea |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2006 |
| Last updated | May 28th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023098811 | NPPES |
| Kentucky | MEDICAID | 60002029 | |
| Kentucky | MEDICAID | 2408513 | |
| Kentucky | MEDICAID | 4002196000 |
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